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NPI 1659420727 · Rapid City, SD · Ambulatory Surgical Clinic/Center
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The Endoscopy Center, Inc. is a ambulatory surgical clinic/center provider located in Rapid City, South Dakota. This profile covers 13 Medicare and 4 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | The Endoscopy Center, Inc. |
| Address | 2820 Mount Rushmore Rd |
| City | Rapid City |
| State | SD |
| ZIP | 57701 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | January 9, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $940.2K |
| Medicaid | $89K |
The provider operates as an Ambulatory Surgical Clinic/Center with a clear gastroenterology endoscopy focus: its Medicare top codes are 45385 (polypectomy during colonoscopy), 45380 (colonoscopy with biopsy), and 43239 (upper endoscopy with biopsy), with Medicare claim volumes of 1.1K, 384, and 531 respectively and revenues of $458K, $112.9K, and $109.4K respectively. This mix of therapeutic colonoscopy (polypectomy/snare) and diagnostic/therapeutic esophagogastroduodenoscopy procedures indicates the center’s primary service line is high-volume outpatient GI endoscopy rather than general surgical or multispecialty procedures.
Medicare revenue is highly concentrated in a small set of endoscopy codes: the precomputed top three Medicare codes account for 72.3% of this provider’s total Medicare revenue. That concentration suggests the facility’s financial performance is closely tied to volume and reimbursement for a narrow set of GI procedures, which can be an operational strength if demand remains steady but creates revenue vulnerability to shifts in utilization or payer policy for those codes.
On Medicare measures this provider is a national outlier on several high-value codes: 45385 generates $458K (48.7% of Medicare revenue) and ranks #48 of 16,310 providers nationally (100th percentile; extreme outlier), while 43239 generates $109.4K (11.6%) and ranks #245 of 17,140 (99th percentile; extreme outlier). 45380 also ranks well above typical national volume at #391 of 16,427 providers (98th percentile), supporting the characterization of the center as a nationally high-volume, specialty endoscopy provider for these services.
Medicaid billing is entirely driven by the same procedural mix: the precomputed top three Medicaid codes account for 100.0% of Medicaid revenue, with 43239 producing $68.5K (76.8% of Medicaid revenue) from 442 claims, 45385 contributing $11.1K (12.4% from 61 claims), and 45380 contributing $9.6K (10.7% from 71 claims). This alignment across payers shows the center is performing the same core GI procedures for Medicaid patients as for Medicare patients, but at substantially lower Medicaid dollar volume.
The provider’s competitive standing differs sharply between payers: nationally it is dominant for key Medicare GI codes (100th and 99th percentile extreme outliers for 45385 and 43239), but within South Dakota Medicaid panels its ranks are modest—43239 ranks #6 of 14 in-state (62th percentile, typical) and 45385 ranks #3 of 5 in-state (50th percentile, typical). In short, the practice is a major national-volume player on Medicare for select endoscopy codes while remaining a moderate participant in the in-state Medicaid market.
Medicare is the primary revenue stream by scale: lifetime Medicare revenue is $940.2K compared with $89K in Medicaid, indicating Medicare receipts are an order of magnitude larger than Medicaid for this provider. That dollar-scale gap implies strategic sensitivity to Medicare policy and utilization trends, as changes in Medicare reimbursement or referral patterns would have a much larger impact on the business than equivalent changes in Medicaid.
The center’s Medicare coding mix also includes preventive and screening work: G0105 (high-risk colorectal cancer screening colonoscopy) contributes $66.3K (7.1% of Medicare revenue) and ranks #292 of 8,773 providers nationally (97th percentile, notably above typical national volume), indicating a meaningful portion of activity is screening-oriented in addition to therapeutic procedures. This combination of screening, diagnostic biopsy (43239), and therapeutic polypectomy (45385) is consistent with a comprehensive outpatient endoscopy workflow that spans prevention through interventional treatment.
The practice has an established operating history with NPI enumeration dated 2007-01-09 (~19 years ago), which supports interpretation of its high accumulated Medicare volumes as the result of long-term, continuous service delivery rather than a recent surge. That tenure combined with the concentrated procedure set and national outlier status on key codes suggests the center is a mature, specialized outpatient endoscopy provider whose performance and market footprint are driven by sustained GI procedural volume.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 1,080 | $430 | $457.9K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 380 | $290 | $112.9K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 530 | $210 | $109.4K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 170 | $400 | $66.3K |
| 43251 | An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of flexible endoscope through the mouth. The physician removes one or more lesions using a snare… | 90 | $560 | $51.1K |
| 43248 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the… | 170 | $250 | $42.1K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 60 | $400 | $25.3K |
| 45390 | The provider performs flexible colonoscopy along with excision of mucous membrane tissue using an endoscope. | 30 | $950 | $24.8K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 50 | $310 | $16.7K |
| 45381 | The provider inserts a flexible endoscope into the anus and navigates the scope through the entire colon. The provider performs one or more injections into the submucosa (the tissue below the mucous… | 60 | $240 | $14.2K |
Showing 1–10 of 13
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 440 | $160 | $68.5K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 60 | $180 | $11.1K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 70 | $140 | $9.6K |
| G8907 | Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer… | 20 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Dakota median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 6 | 10 | 130 | $130 | $77.8K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 6 | 10 | 200 | $180 | $55.8K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 3 | 10 | 60 | $250 | $49.1K |
| G8907 | Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer… | 4 | 10 | 20 | $0 | $0 |
Other providers in the same ZIP code as The Endoscopy Center, Inc., ranked by combined Medicare and Medicaid revenue.
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